How much rates vary
Facilitymedian $288 · 10th to 90th $162 to $1,230Professionalmedian $229 · 10th to 90th $115 to $380
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $186.21 Median $5,128.61 Typical High $8,709.64 | Facility | None | $186.21 | $5,128.61 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $162.18 Typical High $281.84 | Professional | None | $100.00 | $162.18 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $218.78 Typical High $660.69 | Facility | None | $173.78 | $218.78 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $436.52 | Professional | None | $162.18 | $239.88 | $436.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $245.47 Typical High $389.05 | Professional | None | $181.97 | $245.47 | $389.05 |
Moda Health Setting Facility Modifier None Typical Low $186.21 Median $323.59 Typical High $7,943.28 | Facility | None | $186.21 | $323.59 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $102.33 Median $186.21 Typical High $354.81 | Professional | None | $102.33 | $186.21 | $354.81 |
Pacific Source Setting Facility Modifier None Typical Low $154.88 Median $263.03 Typical High $323.59 | Facility | None | $154.88 | $263.03 | $323.59 |
Providence Setting Facility Modifier None Typical Low $173.78 Median $239.88 Typical High $707.95 | Facility | None | $173.78 | $239.88 | $707.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $239.88 Typical High $407.38 | Professional | None | $79.43 | $239.88 | $407.38 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,819.70 Median $2,454.71 Typical High $2,818.38 | Facility | None | $1,819.70 | $2,454.71 | $2,818.38 |
Regence BlueShield Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $331.13 | Professional | None | $208.93 | $295.12 | $331.13 |
United Setting Facility Modifier None Typical Low $354.81 Median $660.69 Typical High $3,630.78 | Facility | None | $354.81 | $660.69 | $3,630.78 |
United Setting Professional Modifier None Typical Low $158.49 Median $269.15 Typical High $436.52 | Professional | None | $158.49 | $269.15 | $436.52 |
13 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $75.86 Typical High $114.82 | Professional | 52 · Reduced service | $63.10 | $75.86 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $30.90 Typical High $46.77 | Professional | 53 · Discontinued | $25.12 | $30.90 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $114.82 Typical High $173.78 | Professional | 54 · Surgery only | $93.33 | $114.82 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $22.91 Typical High $34.67 | Professional | 55 · Aftercare only | $18.62 | $22.91 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $15.14 Typical High $22.91 | Professional | 56 · Pre-op care only | $12.59 | $15.14 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $107.15 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $87.10 | $107.15 | $162.18 |
Moda Health Setting Professional Modifier 51 · Multiple procedures Typical Low $72.44 Median $218.78 Typical High $512.86 | Professional | 51 · Multiple procedures | $72.44 | $218.78 | $512.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $75.86 Typical High $114.82 | Professional | 52 · Reduced service | $63.10 | $75.86 | $114.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $30.90 Typical High $46.77 | Professional | 53 · Discontinued | $25.12 | $30.90 | $46.77 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $114.82 Typical High $173.78 | Professional | 54 · Surgery only | $93.33 | $114.82 | $173.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $22.91 Typical High $34.67 | Professional | 55 · Aftercare only | $18.62 | $22.91 | $34.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $15.14 Typical High $22.91 | Professional | 56 · Pre-op care only | $12.59 | $15.14 | $22.91 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $107.15 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $87.10 | $107.15 | $162.18 |
Where Oregon sits
The same service costs 3.5 times more in Alaska than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Oregon· 7th of 51
$240
AK $447FL $126
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.